Quick question about "snacks"

I have 2 kitties......1 of whom has recently been diagnosed with diabetes. He is currently on 2 units of Vetsulin that I give 30 mins. after he eats. I have to keep them on the same feeding schedule which is set on every 12 hrs. When I'm home, in between these feedings, my kitties keep asking to be fed. Is it okay for me to give them a little low carb "snack" between meals?? Twelve hours seems a long time to go without having something!

 

Some cats do better grazing. You want to pick up the food 2 hours before the next shot and pre-shot test, so that the test is not food-influenced.

Here is our Vetsulin/Caninsulin guide.

 

Thank you, BJM! I'm still in pre-testing phase and haven't gotten my home glucometer yet. Socrates goes back to vet this a.m. for a fluid "bolus". They want to check his BSL today, also.
I am very curious to know where things are at with his levels since we've begun this journey. Will I ever be able to get to a point where we can get away from this 12 hr. schedule and I can do
frequent, SMALL feedings with more frequent checks on his BSL's??? I feel like I am now almost starving them by making them wait 12 hrs. between feeds!! :-( SURELY I can sneak
some healthy, low carb treats in somewhere! I would LOVE to let them go back to "grazing" days and would be more than willing to pick the food up 2 hrs. before the pre-shot test! I hope I
can get this all in my head and how this works SOON!!

 

Although many vets recommend only twice a day feedings, those of us using ProZinc, Lantus, Levemir, and BCP PZI can let our cats graze over the 10 hours after a shot without concern, as the insulin comes in gradually and grazing brings the glucose in gradually, so they match up.
For more harsh insulins, such as NPH and Caninsulin/Vetsulin, you have to test, feed, then wait for a period before shooting, so that the rising glucose can buffer the harsh drop of those insulins. Allowing some mini meals after that may work, such as a mini-meal at +2 or +3 hours post shot of Vetsulin. You'll have to experiment and found out the pattern which best suits your cat.

 

When my cat was first diagnosed he was hungry all the time, but with time and better control of the glucose he wasn't begging so much. Radar has always been a grazer and I didn't change that with the addition of insulin to his routine. I just made sure that whatever food was available during most of the cycle was picked up 2 hours before my preshot test so I got a more accurate test result. Hang in there it will get better as you determine what works best for your cat. And when you have questions please let us know what we can do to help.

 

Is Socrates underweight, Merianne?

 

i thought we were supposed to feed before the test and then give the shot. is the pre-shot test supposed to be fasting for 2 hours or after the pre-shot meal?

 

The sequence is
1, test. 2. Feed. 3. Insulin shot
I pick up the food a couple hours before the test so I'm sure my test is not influenced by the rising glucose levels that happens when there is food in the stomach.
I hope this helps.

 

thanks. this seems like an important detail i missed.

 

Hi there, @Twyla17. (Not sure whether Twyla is your name or your kitty's. )

The preshot blood glucose helps to determine whether or not it's safe to give insulin. If kitty eats in the two hours beforehand then the preshot BG level may be temporarily elevated by the food recently eaten.

The preshot blood test needs to be done shortly before giving insulin. Which insulin is your kitty being treated with?



Mogs
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she's currently on .5u Prozinc every 12 hours. we're always supposed to feed her before giving insulin though right, so the insulin doesn't send her into a coma or something? i guess that's why i'm confused about the testing because won't eating a lot always allow the shot to be ok because the food will send her blood sugar up no matter what? Twyla is our cat's name. we are Joe (me) and Suloni (my wife). more on our situation here: http://www.felinediabetes.com/FDMB/...-get-blood-from-her-ears.142394/#post-1472928

 

Hi Joe and Suloni.

Thank you for the link to your other thread.

Food will only go some way to raising blood glucose, and realistically there is a limit to how much a living being can eat at any one time. In a non-diabetic the pancreas can respond dynamically to the needs of the body and it stops producing insulin when it's not needed. Injected insulin doesn't come with an 'off switch'. Therefore you need to make sure you don't give too much injected insulin at any one time. It's a balancing act, and home testing will help you find the balance.

Feeding before giving insulin ensures that there are carbs available for the insulin to work on.

Unfortunately there is no hard and fast rule about where a cat's blood glucose level will be specifically at any given time. As you start tracking Twyla's numbers you might find that she's in a particular range at preshot time for several days, and that it's OK to give a particular insulin dose. However, there might be a day when she may have been exercising more vigorously or maybe her pancreas might start sputtering out some extra insulin of its own and her preshot will be lower than was typical for her over the previous number of days. Testing before giving insulin will tell you if Twyla's blood glucose is sufficiently high to give insulin safely in the first instance; and testing between injections will allow you to monitor how low a dose takes Twyla (the nadir), plus how long the dose is effective in her system (the duration). Most importantly of all it will help you to spot whether Twyla's blood glucose level is getting too low, in which case you will be able to intervene to provide additional carbohydrates to steer her blood glucose level back into safe numbers. I don't know how much information your vet gave you about what to do in the event that Twyla might show signs of hypoglycaemia, but I certainly wasn't told much; just give her honey or glucose and if necessary bring her in. Managing a potential - or actual - hypo isn't quite as black-and-white as that. The briefing I got of 'hit 'n' hope with the glucose' wasn't nearly enough information. Some cats don't show hypo symptoms, so monitoring clinical signs isn't sufficient to protect a cat. Damage to the cat's body may occur during a hypo regardless of whether or not it is showing symptoms.

Also, a cat's insulin needs are not static. For example, infections can result in higher BG levels and therefore a dose increase may be needed. Conversely once an infection is treated it may result in less need for insulin and therefore a dose decrease would be required. Home testing can help you catch and manage such anomalies and make the necessary adjustments to Twyla's insulin dose.

Home testing and recording the data in a spreadsheet will help you to track Twyla's response to her insulin, learn her BG patterns, and enable you to make good dosing decisions to keep her safe while she's on insulin.


Mogs
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Would you recommend that I ask about switching Insulins?

 

Thanks SO much, Jan!!!

 

Not really, Critter Mom. Socrates and his brother have always been BIG cats (size wise). Their weight had climbed up into the 20 lb range but
will Socrates illness, I believe he's now around 17 lbs. You can tell he has lost weight but I wouldn't say, at this point, it's an unhealthy weight
for him.

 

Thank you for that wonderful explanation!

 

Ok.....so here's where things stand. After taking Socrates back to the vet, yesterday, he received an additional bolus of fluids and they checked his BG
while there. That morning, he was at 151 which is still on the high side but considering he was at 500 when I first brought him in, I was quite pleased!
Meanwhile, I'm not so sure something isn't going on with my other kitty, Purry. Because of the new "12 hr." schedule for Socrates, Purry has had to
fall into the same regime. He's the one that is normally always wanting to be fed. Like Socrates, he too has increased his water intake and has been
like that for a while now. He had been to the vet and had a blood work up approx. 2-3 wks. before Socrates & didn't show any signs of diabetes but
showed a small elevation indicating early stages of renal failure. My concern is that for the past 2 days I've noticed Purry's appetite to be declining.
Today he went about 13 hrs. before I got back in to feed them. Like Socrates, he should have been more than ready to eat. However, he ate a small
portion of what I put out and walked away. Am I over reacting or should I be concerned that there could be something going on with him as well???
Also, given that Socrates is currently taking Vetsulin, can anyone tell me how important it is to inject "exactly" in 30 mins.? If I don't inject any where
from 30 mins. to an hour......is this very detrimental to the dose? Quite honestly, 30 mins. seems to slip away from me quite quickly! I try to remember
to set a timer but sometimes forget. :-/

 

If you aren't giving insulin, you may let them graze.
If either are scarfers, freeze some the meal before, then put out both fresh and frozen. The frozen will be nibbled.
Adding a tablespoon of water will provide more volume and slow down eating, as will spreading the food thinly across a large plate. A large heavy mug may be placed upside down in the middle of the plate to further slow eating.
And a timed feeder like the PetSafe 5 may be really helpful, too.

 

Merianne, some cats do well on Vetsulin (called Caninsulin in Canada and elsewhere) but it does tend to have harsh drops (i.e. blood sugar tends to goes down significantly somewhere between 4-6 hours then rises back up in the last few hours) versus some of the longer acting insulins like Lantus or Levemir. I had Genghis on Caninsulin for about a month and a half but, since cats have a better chance of remission if you can keep them in better numbers throughout the day, I switched her to Lantus.

The notion that Vetuslin/Caninsulin is "not as good" because it was developed for dogs (which it was) is a bit of a non-sequitur to me, since Lantus and Levemir were developed for humans. The real issue is the tendency toward harsh drops and lack of 12 hour duration for Caninsulin when used in cats, which have a much faster metabolism. Lantus tends to have a smoother and gentler action and tends to last to the 12 hour "next shot" better - at least it did for Genghis.

@CritterMom once said if you could draw a glucose curve for Caninuslin, it would look like a cup; graphing it out for Lantus looks more like a saucer. If you're a data-hound, have a look at Genghis' spreadsheet and see the difference in her response to Lantus versus Caninsulin. I have been very pleased with the results, though I did give Caninsulin the good old college try!

Hope that helps!

 

Kitties with chronic kidney disease (CKD) tend to suffer from nausea. Here is a link to the nausea and appetite page on Tanya's Site. Check to see if he has any symptoms and let your vet know. (There are lots of tips on the site about how to tempt nauseated kitties to eat.) In the first instance, try raising Purry's food and water bowls to see if he's more keen to eat from them.

Tanya's Site is the best place on the internet to learn how to care for kitties with CKD. It is well-researched and well-respected. There's also a support group associated with the site (link on the home page). They're very friendly, knowledgeable, and helpful.


Mogs
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Some cats do OK on Vetsulin; some not so much. There are pros and cons to working with different insulins. Lantus and Levemir (both depot insulins - they build up a little 'storehouse' of insulin in the cat's body) - really work best when they are dosed consistently (including at a regularly scheduled time). Prozinc and PZI (in-out insulins - dose usually peters out by the end of each cycle) can offer a little bit of flexibility. Current research indicates that cats treated with longer-acting, more cat-friendly insulins have a statistically greater chance of achieving remission. That said, some cats do achieve remission when treated with Vetsulin.

Like Melanie (@Brashworks) Saoirse started on Caninsulin (no choice - legal requirement in the UK) but I was able to get her switched to Lantus. I had to stop giving Saoirse Caninsulin because the harsh drops threatened to send her regularly into hypo territory but when it was stopped she could not hold the lower numbers for any length of time after I suspended its administration. The gentler action of Lantus allowed me to continue giving Saoirse insulin for another few months. This additional support allowed her pancreas to heal enough to become diet-controlled.

I hope the above may be useful to you in making your decision. If I had had the choice of which insulin Saoirse would be treated with from day one, I would have opted for Lantus.


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